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GUIDELINES FOR THE MEDICAL WASTE MANAGEMENT <br />PLAN <br />Small quantity generators that provide Onsite Treatment and all large quantity generators <br />shall have a Medical Waste Management plan on file with the San Joaquin County <br />Environmental Health Department. The Medical Waste Management Plan shall contain the <br />following information as appropriate for your facility: <br />Business Name: <br />Business Address: <br />w� <br />Phone Number: <br />Type of Facility or Businc <br />State Zip Code <br />❑ Small Quantity Generator with Onsite Treatment (Generates less than 200lbs/month). <br />Large Quantity Generator Only (Generates 200 lbs or more/month). <br />❑ Large Quantity Generator with Onsite Treatment (Generates 200 lbs or more/month). <br />Person responsible for implementation of the Medical Waste Management Plan: <br />Name: n _ Title: <br />ct c <br />Phone: PQJ '�_ Date: <br />—!��2d, <br />1. List the types of medical waste generated at your facility, i.e., laboratory wastes, blood or body <br />fluids, sharps, conta#Tated apimals, surgical specigens, trace chemo or isolation wastes": <br />a) Do you generate M pharmaceutical waste (expired/outdated, spent, partials,)? <br />b) PYes ❑ No <br />If yes, describe the type of pharmaceutical waste (expired, spent, partials, outdated, patient <br />returns, etc): <br />And estimate the monthly amount of pharmaceutical waste generated at your <br />facility: i l6,4_ <br />EHD 45-03 <br />10/6/2006 <br />